While it's true that more Australians and New Zealanders die of coronary heart disease (CHD) than any other illness, times are changing. You're now less likely to succumb to a fatal CHD-related heart attack, thanks to better prevention awareness and treatments.
Your heart is a giant muscle that needs lots of fuel (oxygen and various nutrients) to operate. A web of blood vessels called coronary arteries surround it just to provide this vital service. In a healthy heart, freshly oxygenated, nutrient-rich blood flows freely though smooth, flexible arteries. A diagnosis of coronary heart disease (CHD), however, means that the insides of the vessels have become clogged with fatty streaks called plaque. Blood can no longer flow so effortlessly.
Sometimes, arteries get so plaque-riddled and narrowed that your heart receives an insufficient amount of oxygen-rich blood. Exert yourself--run for the bus, mow the lawn, climb onto the treadmill your kids gave you on your last birthday--and your heart may nearly scream out for more oxygen. Below your breastbone, deep in your chest, come warning signs: an uncomfortable tightness and the sense that an elephant is standing on your chest. This is angina, a wave of crushing pain that may spread down your arms and up to your jaw (see on shortly). And if one of the coronary arteries has become completely blocked, that part of your heart will get no oxygen at all. This is a heart attack.
Luckily, there are many things you can do to stop--and even reverse--this alarming progression of events. In taking charge of your CHD, you'll not only be able to prevent a heart attack but also reduce your chances of developing conditions associated with heart disease, such as congestive heart failure (see on previous) and heart rhythm disturbances such as trial fibrillation (see on previous).
LIKELY FIRST STEPS
QUESTIONS TO ASK
The way you live your life--eating properly, exercising, not smoking, controlling your weight, reducing your stress-will be the determining factor when it comes to preventing and even reversing CHD. If you make (and stick to) whatever lifestyle changes are required, the odds are in your favour that you'll lead a normal life.
Depending of what's causing your CHD (atherosclerosis, the accumulation of plaque on arterial walls, is the most common culprit), certain medications can help. For milder cases, a daily aspirin or stronger prescription medications can lower your risk of stroke or heart attack. For severe cases, surgery can be a lifesaving option. Unfortunately, none of these will curve you of CHD. But the right procedure, an angioplasty or a bypass, can give you enormous relief from pain and discomfort--and significantly prolong life.
What is happening
Your heart is a giant muscle that needs lots of fuel (oxygen and various nutrients) to operate. A web of blood vessels called coronary arteries surround it just to provide this vital service. In a healthy heart, freshly oxygenated, nutrient-rich blood flows freely though smooth, flexible arteries. A diagnosis of coronary heart disease (CHD), however, means that the insides of the vessels have become clogged with fatty streaks called plaque. Blood can no longer flow so effortlessly.
Sometimes, arteries get so plaque-riddled and narrowed that your heart receives an insufficient amount of oxygen-rich blood. Exert yourself--run for the bus, mow the lawn, climb onto the treadmill your kids gave you on your last birthday--and your heart may nearly scream out for more oxygen. Below your breastbone, deep in your chest, come warning signs: an uncomfortable tightness and the sense that an elephant is standing on your chest. This is angina, a wave of crushing pain that may spread down your arms and up to your jaw (see on shortly). And if one of the coronary arteries has become completely blocked, that part of your heart will get no oxygen at all. This is a heart attack.
Luckily, there are many things you can do to stop--and even reverse--this alarming progression of events. In taking charge of your CHD, you'll not only be able to prevent a heart attack but also reduce your chances of developing conditions associated with heart disease, such as congestive heart failure (see on previous) and heart rhythm disturbances such as trial fibrillation (see on previous).
LIKELY FIRST STEPS
- Lifestyle changes (low-fat diet, exercise, weight loss, smoking cessation, stress reduction) to naturally halt or even reverse the disease.
- In tandem with lifestyle measures, medications (such as antiplatelets, beta-blockers and cholestered drugs) to slow the disease, prevent complications and control angina.
- For more severe disease, surgery (coronary artery bypass, angioplasty) to relieve symptoms and prevent impending heart attack or stroke.
- Am I in good enough shape to start exercising right away?
- Which of my coronary arteries is blocked? Will my treatment change if it's the left interior descending artery--which supplies up to 80% of the heart's blood?
- What type of blockage do I have (small and soft? large and close to a bend in the artery? long and hardened?) and how does this alter my treatment plan?
- Is it safe to have sex? Can I still take Viagra?
Treatments
The way you live your life--eating properly, exercising, not smoking, controlling your weight, reducing your stress-will be the determining factor when it comes to preventing and even reversing CHD. If you make (and stick to) whatever lifestyle changes are required, the odds are in your favour that you'll lead a normal life.
Depending of what's causing your CHD (atherosclerosis, the accumulation of plaque on arterial walls, is the most common culprit), certain medications can help. For milder cases, a daily aspirin or stronger prescription medications can lower your risk of stroke or heart attack. For severe cases, surgery can be a lifesaving option. Unfortunately, none of these will curve you of CHD. But the right procedure, an angioplasty or a bypass, can give you enormous relief from pain and discomfort--and significantly prolong life.
Treatment Options
LIFESTYLE CHANGES
------------------------------------------------------------------------------------------------------------------------------------------
Diet Heart-healthy eating makes a big difference.
------------------------------------------------------------------------------------------------------------------------------------------
Exercise Regular, raise-a-sweat activities are the goal.
------------------------------------------------------------------------------------------------------------------------------------------
Lose weight Helps lower cholesterol and blood pressure.
------------------------------------------------------------------------------------------------------------------------------------------
Stop smoking Risk of CHD drops automatically in three years.
-------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction May actually reverse CHD damage.
MEDICATIONS
-------------------------------------------------------------------------------------------------------------------------------------------
Antiplatelet agents Daily low-dose aspirin or clopidogrel.
------------------------------------------------------------------------------------------------------------------------------------------
Antihypertensives Lower high blood pressure to reduce heart risk.
------------------------------------------------------------------------------------------------------------------------------------------
Beta-blockers Significantly reduce risk of dying from CHD.
------------------------------------------------------------------------------------------------------------------------------------------
Calcium channel blockers Open heart vessels and help angina.
------------------------------------------------------------------------------------------------------------------------------------------ Cholesterol-lowering drugs Prevent heart attacks in CHD patients.
-------------------------------------------------------------------------------------------------------------------------------------------- ACE inhibitors Good for someone who's had a heart attack.
PROCEDURES -----------------------------------------------------------------------------------------------------------------------------------------
Coronary artery bypass Open heart surgery creates new pathways.
----------------------------------------------------------------------------------------------------------------------------------------
Angioplasty, w/wo stent Ballon-tipped catheter compresses plaque.
LIFESTYLE CHANGES
------------------------------------------------------------------------------------------------------------------------------------------
Diet Heart-healthy eating makes a big difference.
------------------------------------------------------------------------------------------------------------------------------------------
Exercise Regular, raise-a-sweat activities are the goal.
------------------------------------------------------------------------------------------------------------------------------------------
Lose weight Helps lower cholesterol and blood pressure.
------------------------------------------------------------------------------------------------------------------------------------------
Stop smoking Risk of CHD drops automatically in three years.
-------------------------------------------------------------------------------------------------------------------------------------------
Stress reduction May actually reverse CHD damage.
MEDICATIONS
-------------------------------------------------------------------------------------------------------------------------------------------
Antiplatelet agents Daily low-dose aspirin or clopidogrel.
------------------------------------------------------------------------------------------------------------------------------------------
Antihypertensives Lower high blood pressure to reduce heart risk.
------------------------------------------------------------------------------------------------------------------------------------------
Beta-blockers Significantly reduce risk of dying from CHD.
------------------------------------------------------------------------------------------------------------------------------------------
Calcium channel blockers Open heart vessels and help angina.
------------------------------------------------------------------------------------------------------------------------------------------ Cholesterol-lowering drugs Prevent heart attacks in CHD patients.
-------------------------------------------------------------------------------------------------------------------------------------------- ACE inhibitors Good for someone who's had a heart attack.
PROCEDURES -----------------------------------------------------------------------------------------------------------------------------------------
Coronary artery bypass Open heart surgery creates new pathways.
----------------------------------------------------------------------------------------------------------------------------------------
Angioplasty, w/wo stent Ballon-tipped catheter compresses plaque.
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